Does glucose intolerance associate with increased ultrasonographic manifestations of carotid atherosclerosis in elderly men?
In elderly men, glucose intolerance and hyperinsulinemia do not appear to be major contributors to carotid atherosclerosis, potentially due to lower rates of smoking and lower cholesterol levels in diabetic individuals.
OBJECTIVE: To study the association of ultrasonographic manifestations of common carotid atherosclerosis with glucose intolerance in survivors of the cohort of men born in 1900-1919 in eastern Finland. RESEARCH DESIGN AND METHODS: Carotid ultrasonography was carried out for 182 men in 1989. Glucose tolerance status classified based on an oral glucose tolerance test in 1984 and 1989 surveys was used in both prospective and cross-sectional analyses. RESULTS: Carotid atherosclerosis was common in men aged 70-89 years. There was no significant difference in the maximal carotid intimal-medial thickness between diabetic and nondiabetic men and over different age-groups; it was 1.28, 1.33, and 1.36 mm in subjects with diabetes, impaired glucose tolerance, and normal glucose tolerance, respectively (P = 0.69). No association between the presence of a nonmineralized or a mineralized atherosclerotic lesion with diabetes was found. Fasting plasma insulin did not relate to ultrasonographically detectable atherosclerotic lesions. CONCLUSIONS: Hyperglycemia and hyperinsulinemia may not be main contributors to atherosclerosis in elderly men, partly because smoking is less common and total and LDL cholesterol concentrations are lower in diabetic men than in men with normal glucose tolerance.
Tuomilehto et al. (Sat,) studied this question.